Catheter system and methods of using same

ABSTRACT

Some embodiments are directed to a catheter system comprising an introducer having a main body, an introducer sheath projecting from the main body, and a first seal supported within the introducer and a catheter having a main body, an outer sheath projecting from the main body, a second seal supported within the catheter, and an inner core configured to be advanced axially through the main body, the second seal, and the outer sheath. The introducer can be configured to be selectively engageable with the catheter so that the catheter can be selectively and removably linked with the introducer in the axial direction. The catheter system can also be configured such that, when the introducer and the catheter are linked, the catheter can be rotatable relative to the introducer. The introducer can be configured to radially restrain an endoluminal prosthesis.

PRIORITY CLAIM AND INCORPORATION BY REFERENCE

This application is a continuation of U.S. patent application Ser. No.13/544,426, filed Jul. 9, 2012, which is a continuation of U.S. patentapplication Ser. No. 12/496,446, now U.S. Pat. No. 8,216,295, filed onJul. 1, 2009 (entitled “CATHETER SYSTEM AND METHODS OF USING SAME”),which claims the benefit under 35 U.S.C. § 119 of U.S. ProvisionalPatent Application No. 61/077,429, filed Jul. 1, 2008 (entitled“CATHETER SYSTEM AND METHODS OF USING SAME”), and U.S. ProvisionalPatent Application No. 61/184,742, filed Jun. 5, 2009 (entitled“CATHETER SYSTEM AND METHODS OF USING SAME”), the entirety of each ofwhich is hereby incorporated by reference as if fully set forth herein.

BACKGROUND OF THE INVENTION

Technical Field

The present invention relates to catheter systems, in particular,catheter systems having an introducer.

Description of the Related Art

Introducers or introducer sheaths are used for minimal invasiveplacement of catheters into blood vessels. They typically consist of atubing that is inserted into the blood vessel and a seal or valve at theproximal end of the tubing which is positioned outside of the body. Theseal provides a hemostasis seal against blood loss. Catheters used fordiagnostic or therapeutic means are typically passed through theintroducer into the blood vessel. The introducer sheath thus providescontinuous access for catheters, protects the inner wall of the bloodvessel against damage during catheter insertion, and provides ahemostasis seal against blood loss.

There are situations in which the catheters require substantialmaneuvering within the blood vessel. For example, placement of a stentor stent graft may require the delivery catheter to be positionedprecisely axially as well as possible rotationally into a specificlocation within the blood vessel. In addition deployment of the stentmay require precise operation of the delivery system within theintroducer. In these situations, the operator has to carefully controlboth the position of the introducer and the delivery system. Thissometimes requires assistance by a second operator.

SUMMARY OF THE INVENTION

Some embodiments disclosed herein pertain to a catheter system for theinsertion and positioning of diagnostic or therapeutic devices intoblood vessels. In some embodiments, the system comprises an introduceror an introducer sheath and at least one catheter. The catheter can beintroduced through the introducer into the blood stream. A dockingmechanism can engage the proximal end of the introducer with theproximal end of the catheter and can prevent axial movement between theintroducer and the catheter.

In some embodiments, a catheter system can comprise an introducer and acatheter, wherein the introducer can comprise a sheath (that can betubular) and a seal that can be an adjustable hemostasis valve connectedto the proximal of the sheath. The introducer can define a proximal endand a distal end, and the catheter can be configured to engage with theproximal end of the introducer. The introducer and the catheter can beconfigured such that the catheter can be slidingly received within theintroducer. The introducer and the catheter can be configured such thatthe catheter can removably engage with the introducer such that, whenthe catheter is engaged with the introducer, the catheter will beaxially fixed to the introducer so as to prevent substantial axialmovement between the introducer and the catheter and so that thecatheter and introducer can be manipulated in an axial direction as asingle unit.

Additionally, in some embodiments, the catheter and introducer can beconfigured such that, when the catheter is engaged with the introducer,an inner core of the catheter can be rotatable relative to theintroducer and the introducer sheath. Further, in some embodiments, thecatheter can be configured such that the inner core of the catheter canbe locked or substantially prevented from rotational movement relativeto the outer sheath of the catheter and/or relative to the introducer.

In some embodiments, a method of placement of a catheter into a bloodvessel is provided, wherein the catheter is passed through an introducersheath and the proximal end of the introducer sheath physically engageswith, or is removably docked with, the catheter to prevent substantialaxial motion between the introducer sheath and the catheter.

Some stents or stent grafts (collectively referred to herein as a stentor stents) may require precise placement in both axial andcircumferential direction. For example, stents or stent grafts withfenestrations require accurate placement of the fenestration at thebranch vessel. The embodiments of the catheter systems disclosed hereincan be configured to allow for the rotation of the delivery catheterand, hence, the stent, relative to the introducer sheath. In tight andcalcified vessels there is often considerable friction between the outersheath of the catheter and the vessel wall. In some of the embodimentsdisclosed herein, the delivery catheter and introducer can be configuredsuch that the outer sheath of the delivery catheter will not be indirect contact with the vessel wall during the stent delivery procedure.Rather, in some embodiments, some or all of the length of the outersheath of the delivery catheter can be contained within the introducersheath, and the introducer sheath can be in direct contact with thevessel wall. This can considerably reduce the force required to rotatethe delivery system relative to the patient's vessel. Accordingly, thedelivery catheter and the introducer can be configured such that thedelivery catheter can be substantially free to rotate within theintroducer sheath.

In some embodiments, the friction that can otherwise impede therotational freedom of the delivery catheter can be further reduced bylining the inner surface of the introducer sheath with a low-frictioncoating such as PTFE or applying hydrophilic coating to the outersurface of the delivery catheter or the inner surface of the introducersheath.

Thus, in some embodiments, the introducer sheath can remain rotationallystatic or still while the deployment catheter is rotated within theintroducer sheath. This can protect the delivery catheter and stent frombeing damaged, torqued, or stressed during the rotational manipulationof the delivery catheter and stent, and also prevent any damage orstress on the vessel wall from the rotation of the delivery catheter orstent.

Additionally, in some embodiments, delivery catheter can be configuredto permit a user or medical practitioner to selectively control orprevent the rotational freedom of the delivery catheter and stentrelative to the introducer, or the inner core of the delivery catheterand stent relative to the outer sheath of the delivery catheter. Forexample, in some embodiments, the delivery catheter can comprise athreaded hub supported at the proximal end portion of the deliverycatheter configured to selectively constrict or tighten against an outerwall of the inner core of the delivery catheter. By constricting the hubagainst the inner core, the inner core can be prevented or inhibitedfrom rotating relative to the introducer. By loosening the hub relativeto the inner core, the rotational freedom of the inner core or deliverycatheter relative to the introducer sheath can be restored.

In some embodiments, the hemostasis valve of the introducer sheath canbe opened and closed by rotating the handle of the introducer sheath soas to be adjustable. Active adjustment of the hemostasis valve may bedesired to seal against catheters with a wide range of diameters. Thedocking mechanism can allow the handle of the introducer sheath to beoperated (i.e. rotated) while a catheter is inserted in and docked tothe introducer sheath. Furthermore, the catheter can be rotationallylocked by closing the valve.

Some embodiments are directed to a catheter system that can comprise anintroducer comprising a main body, a introducer sheath projecting fromthe main body, and a first seal (which can be a rubber seal, aninterference or close tolerance fit between adjacent components, anadjustable hemostasis valve, or any other suitable sealing component orfeature) supported within the introducer, and a catheter comprising amain body, a outer sheath projecting from the main body, a second seal(which can be a rubber seal, an interference or close tolerance fitbetween adjacent components, an adjustable hemostasis valve, or anyother suitable sealing component or feature) supported within thecatheter, and an inner core that is advanceable through the main body,the second seal, and the outer sheath. The first seal can be configuredto at least inhibit a flow of blood through the introducer when thecatheter is engaged with the introducer. The second seal can beconfigured to at least inhibit a flow of blood through the catheter. Theintroducer sheath can be configured to axially receive at least theinner core therethrough. In some embodiments, the introducer can beconfigured to be selectively engageable with the catheter so that thecatheter can be selectively and removably linked with the introducer inthe axial direction such that, when the introducer and the catheter arelinked, the axial movement of either of the introducer and the catheterwill cause the simultaneous and equal axial movement of the other of theintroducer and the catheter. In some embodiments, the catheter systemcan be configured such that, when the introducer and the catheter arelinked, the catheter is rotatable relative to the introducer.

Some embodiments are directed to a catheter system that can comprise anintroducer comprising a main body and an introducer sheath projectingfrom the main body, a catheter comprising a main body, a outer sheathprojecting from the main body, and an inner core that is advanceablethrough the main body and the outer sheath. In some embodiments, theinner core can be configured to axially support a stent such that thestent can be advanced through the outer sheath by advancing the innercore through the outer sheath. The outer sheath can be configured toradially restrain the stent so that no additional radial restraint isrequired. In some embodiments, the outer sheath can be configured toradially restrain the stent in addition to other forms of restraint. Theintroducer sheath can be configured to axially receive at least theinner core therein. In some embodiments, the catheter system can beconfigured such that the outer sheath of the catheter does not advanceinto the introducer sheath when the catheter is fully axially advancedinto the introducer. In some embodiments, the introducer sheath can beconfigured to directly radially restrain the stent while the stent ispositioned within the introducer sheath.

Therefore, in some embodiments, the outer sheath of the catheter and theintroducer sheath can be configured to provide a lumen having agenerally uniform cross-sectional size through the catheter systemthrough which the endoluminal prosthesis can be advanced. In someembodiments, the lumen through the catheter system through which theendoluminal prosthesis can be advanced can be substantially continuous,so that the endoluminal prosthesis can be advanced through the cathetersystem without the prosthesis being obstructed by or snagging on anycomponents or features of the catheter system as it is being advanced.In some embodiments, the lumen can be substantially continuous but haveshort gaps on the order of approximately 1 mm to approximately 3 mm inthe lumen such as, without limitation, adjacent to the distal end of theouter sheath of the catheter and/or adjacent to the proximal end of theintroducer sheath. Further, in some embodiments, one or more surfaces ofother components comprising the catheter or the introducer in additionto the outer sheath and the introducer sheath, such as withoutlimitation the main body of the introducer, can form portions of thelumen through the catheter system.

Some embodiments are directed to a method of deploying a stent in ablood vessel, comprising positioning an introducer within a patient'sblood vessel so as to advance an introducer sheath of the introducerinto the patient's blood vessel, the introducer having a proximal endportion and a distal end portion, advancing an outer sheath of acatheter into the introducer so that an end portion of the outer sheathof the catheter is positioned approximately adjacent to the proximal endportion of the introducer sheath and such that no portion of the outersheath overlaps the introducer sheath, the catheter further comprisingan inner core that is axially moveable within the outer sheath, axiallysupporting a stent with the inner core, axially advancing the inner coreand the stent through the outer sheath of the catheter, through theintroducer sheath, and past the distal end of the introducer sheath, anddeploying the stent in the blood vessel.

BRIEF DESCRIPTION OF THE DRAWINGS

These and other features, aspects and advantages will now be describedin connection with certain embodiments, in reference to the accompanyingdrawings. The illustrated embodiments, however, are merely examples andare not intended to be limiting. The following are brief descriptions ofthe drawings.

FIG. 1A is a schematic representation of an embodiment of a cathetersystem comprising a docking arrangement to physically engage a catheterwith an introducer sheath.

FIG. 1B is a schematic representation of the embodiment of the cathetersystem shown in FIG. 1A, showing the catheter engaged with theintroducer sheath.

FIG. 2A is a schematic representation of another embodiment of acatheter system comprising a docking arrangement to physically engage acatheter with an introducer sheath.

FIG. 2B is a schematic representation of the embodiment of the cathetersystem shown in FIG. 2A, showing the catheter engaged with theintroducer sheath.

FIG. 2C is a schematic representation of the embodiment of the cathetersystem shown in FIG. 2A, showing a mechanism for disengaging thecatheter from the introducer sheath.

FIG. 3A is a schematic representation of another embodiment of acatheter system comprising a docking arrangement to physically engage acatheter with an introducer sheath, the catheter system being configuredto deliver a stent or stent graft into a blood vessel.

FIG. 3B is a schematic representation of the embodiment of the cathetersystem shown in FIG. 3A, showing the catheter engaged with theintroducer sheath.

FIG. 3C is a schematic representation of the embodiment of the cathetersystem shown in FIG. 3A, illustrating the axial insertion of anembodiment of a stent into the tubular sheath of the embodiment of theintroducer sheath shown in FIG. 3A.

FIG. 3D is a schematic representation of the embodiment of the cathetersystem shown in FIG. 3A, illustrating the embodiment of the stent beingdeployed after the tubular sheath of the embodiment of the introducersheath shown in FIG. 3A has been retracted from the stent.

FIG. 4 is a perspective view of an embodiment of a catheter systemcomprising an embodiment of an introducer and an embodiment of adelivery catheter.

FIG. 5 is a perspective view of the embodiment of the introducer shownin FIG. 4.

FIG. 6A is a first exploded assembly view of the embodiment of theintroducer shown in FIG. 5.

FIG. 6B is a second exploded assembly view of the embodiment of theintroducer shown in FIG. 5.

FIG. 7 is a perspective view of the embodiment of the delivery cathetershown in FIG. 4.

FIG. 8A is a first exploded assembly view of the embodiment of thedelivery catheter shown in FIG. 7.

FIG. 8B is a second exploded assembly view of the embodiment of thedelivery catheter shown in FIG. 7.

FIG. 9 is a perspective view of the embodiment of the catheter systemshown in FIG. 4, showing the delivery catheter before the dockingmechanism of the delivery catheter has been engaged with the dockingmechanism of the introducer.

FIG. 10 is a perspective view of the embodiment of the catheter systemshown in FIG. 4, showing the delivery catheter after the dockingmechanism of the delivery catheter has been engaged with the dockingmechanism of the introducer.

FIG. 11 is an end view of the embodiment of the catheter system shown inFIG. 4.

FIG. 12 is a section view of the embodiment of the catheter system shownin FIG. 4, taken through the line 12-12 of FIG. 11.

FIG. 13 is an enlarged section view of the embodiment of the cathetersystem shown in FIG. 4, defined by curve 13-13 of FIG. 12.

FIG. 14 is an enlarged section view of the embodiment of the cathetersystem shown in FIG. 4, defined by curve 14-14 of FIG. 13.

FIG. 15 is a section view of the embodiment of the catheter system shownin FIG. 4, taken through the line 15-15 of FIG. 11.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

The following detailed description is now directed to certain specificembodiments of the disclosure. In this description, reference is made tothe figures wherein like parts are designated with like numeralsthroughout the description and the drawings. Described below are variousembodiments of a catheter system that can comprise an introducer sheathand a docking arrangement. In some embodiments, the catheter systemsdisclosed herein can be used in diagnostic or therapeutic proceduressuch as, but not limited to, endoluminal vascular prosthesis deploymentprocedures.

FIG. 1A is a schematic representation of an embodiment of a cathetersystem 10 comprising a docking arrangement configured to physicallyengage a catheter 20 with an introducer 12. FIG. 1B is a schematicrepresentation of the catheter system 10 shown in FIG. 1A, showing thecatheter 20 engaged with the introducer 12. In some embodiments, thecatheter 20 or any catheter disclosed herein can be a diagnostic ortherapeutic catheter, or any other suitable catheter. In someembodiments, the introducer 12 can comprise a tubular sheath 14, a seal16, and a female docking mechanism 18. The first seal 16 can be a rubberseal, an interference or close tolerance fit between adjacentcomponents, an adjustable hemostasis valve, or any other suitablesealing component or feature.

In some embodiments, the catheter 20 can have a shaft 24 and a maledocking mechanism 22. In some embodiments, as illustrated in FIG. 1B,the catheter 20 can be inserted into the introducer 12 and the femaledocking mechanism 18 can be engaged with the male docking mechanism 22.In some embodiments, the docking mechanism can prevent the introducer 12and the catheter 20 from moving axially with respect to each other whenthe docking mechanism is engaged. Additionally, in some embodiments, thecatheter system 10 can be configured so that the catheter 20 can rotatewithin the introducer 12, even when the catheter 20 is docked with theintroducer 12.

As mentioned, the introducer 12 can comprise a tubular introducer sheath14 and a seal 16 (which, again, can be a rubber seal, an interference orclose tolerance fit, an adjustable hemostasis valve, or any othersuitable sealing component or feature) connected to the proximal end ofthe introducer sheath 14. In some embodiments, the overall design of thesheath 14 and seal 16 may be similar to the design of commerciallyavailable introducers, or any other introducers presently known or laterdeveloped. The catheter 20 can have an outside dimensional profile thatis sized and/or configured to pass through the introducer sheath 14. Asdiscussed above, in some embodiments, the proximal end of the catheter20 and the proximal end of the introducer sheath 14 can be configured topermanently or removably engage with each other, and to allow for therotation of the catheter 20 within the introducer sheath 14 whilesubstantially limiting the axial movement of the catheter 20 withrespect to the introducer sheath 14.

In some embodiments, after engagement of the catheter and introducer,the combined system can be operated by a single operator. As mentioned,the catheter system 10 can be configured so that the catheter 20 cansubstantially freely rotate within the introducer sheath 14, which canallow for precise rotational positioning of the catheter within theintroducer. After completion of the procedure, the catheter 20 can bedisengaged from the introducer 12 so that the catheter 20 can be removedfrom the patient's body. Additionally, the introducer 12 can berepositioned for a second intervention and a second catheter can beinserted and engaged with the introducer 12 for additional procedures.

FIG. 2A is a schematic representation of an embodiment of a cathetersystem 40 comprising a docking arrangement to physically engage acatheter 50 with an introducer 42. FIG. 2B is a schematic representationof the embodiment of the catheter system 40, showing the catheter 50engaged with the introducer 42. FIG. 2C is a schematic representation ofthe embodiment of the catheter system 40 shown in FIG. 2A, showing amechanism for disengaging the catheter 50 from the introducer 42.

In some embodiments, the catheter system 40 can have a male dockingmechanism 52 and a shaft 54. The introducer 42 can comprise a tubularsheath 44, a seal 46, and a female docking mechanism 48. In particular,FIG. 2C schematically illustrates that the catheter 50 can be disengagedfrom the male docking mechanism 52 and the introducer 42 by compressingthe levers or tabs 56. Accordingly, in the illustrated embodiment, themale docking mechanism 52 can be elongated and can comprise levers 56.

FIG. 3A is a schematic representation of another embodiment of acatheter system 60 comprising a docking arrangement to physically engagea catheter 70 with an introducer 62, the catheter system 60 beingconfigured to deliver a stent or stent graft 80 into a blood vessel.FIG. 3B is a schematic representation of the embodiment of the cathetersystem 60 shown in FIG. 3A, showing the catheter 70 engaged with theintroducer 62. FIG. 3C is a schematic representation of the embodimentof the catheter system 60 shown in FIG. 3A, illustrating the axialinsertion of an embodiment of a stent or stent graft 80 into the tubularsheath 64 of the embodiment of the introducer 62 shown in FIG. 3A. FIG.3D is a schematic representation of the embodiment of the cathetersystem 60 shown in FIG. 3A, illustrating the embodiment of the stent 80being deployed after the tubular sheath 64 of the embodiment of theintroducer 62 shown in FIG. 3A has been retracted from the stent 80.

Self-expanding stent or stents grafts are typically retained in adeployment sheath within the delivery catheter. The deployment sheathcan protect the stent or stent graft and the vessel wall from damageduring insertion and can retain the stent or stent graft in a collapsedlow-profile configuration during delivery. The stent or stent graft canbe deployed in the desired position of the blood vessel by removing thedeployment sheath and allowing the stent or stent graft to radiallyexpand against the wall of the blood vessel. In order to pass such adelivery catheter into the desired blood vessel, the catheter system canbe configured so that the inner diameter of the introducer sheath islarger than the outer diameter of the deployment sheath. Cliniciansprefer a low profile of the introducer sheath to minimize damage to theblood vessel and allowing for access into small blood vessels. It can bedesired to minimize the profile of the delivery catheter.

Cartridge systems have been developed, in which the stent or stent graftcan be transferred from delivery sheath into the introducer sheath andthe stent or stent graft can be passed through the introducer sheath tothe target location. In such a cartridge system, the introducer sheatheffectively acts as a deployment sheath. The transfer eliminates theneed of a second sheath and minimizes the profile of the system in theblood vessel. The docking arrangement of the current invention providesa secure engagement of the delivery catheter and the introducer sheathprior to transfer of the stent or stent graft into the introducersheath. This prevents potential user errors in the transfer and furtherconverts the delivery catheter and introducer sheath into a single-usersystem.

As illustrated in FIGS. 3A-3D, the catheter system 60 can be used totransfer and deploy a stent or stent graft 80 into a blood vessel (bloodvessel not shown). As illustrated therein, the introducer 62 cancomprise a tubular sheath 64 that can be inserted into the body of thepatient. The proximal end 62 a of the introducer 62 can be sized and/orconfigured to accommodate the deployment sheath 74 of the catheter 70.The introducer sheath can also have a seal 66 (referred to herein as afirst seal) and a female docking mechanism 68, similar to any of theembodiments of the seal, hemostasis valve, and/or docking mechanismsdescribed above. The seal 66 can be an annular rubber seal (asillustrated), an interference or close tolerance fit between adjacentcomponents, an adjustable hemostasis valve, or any other suitablesealing component or feature. The stent delivery catheter 70 cancomprise an inner core 78, a pocket 82 that can house the collapsedstent 80, a deployment sheath 74 that can retain the collapsed stent 80,and a catheter tip 76.

As illustrated in FIG. 3B, in some embodiments, the catheter 70 can beinserted into the introducer 62 when the docking mechanisms 68 and 72are engaged. In some embodiments (not illustrated), the deploymentsheath 74 of the delivery catheter 70 can be sized and configured to bereceived within the larger diameter proximal end 62 a of the introducersheath and to extend into the distal tubular sheath 64 of the introducer62. Alternatively, in some embodiments, the deployment sheath 74 of thedelivery catheter 70 can be sized and configured to be received withinthe larger diameter proximal end 62 a of the introducer sheath but notthe distal tubular sheath 64 of the introducer 62. In some embodiments,as illustrated in FIGS. 3C and 3D, the deployment sheath 74 and thetubular sheath 64 can be sized and configured such that, when thedeployment sheath 74 has advanced through the proximal end 62 a of theintroducer sheath, the similar size or shape of the distal tubularsheath 64 can prevent the deployment sheath 74 from advancing throughthe distal tubular sheath 64. In some embodiments, the inner and/orouter diameters of the deployment sheath 74 and the tubular sheath 64can be substantially the same.

As illustrated in FIG. 3C, in some embodiments, the inner core 78 of thecatheter 70 can be pushed distally, thereby transferring the stent 80from the deployment sheath 74 into the tubular sheath 64 of theintroducer 62. The stent 80 can be advanced until the catheter tip 76reaches the distal end of the tubular sheath 64. In this configuration,the catheter/introducer system effectively becomes a single-unitdeployment catheter. Thus, in some embodiments, the tubular sheath 64can function as a deployment sheath. In some embodiments, the stent 80can be advanced in a collapsed configuration within the protectiveintroducer 62 to the target location in the blood vessel withoutincreasing the profile of the delivery system. If the delivery catheterwere passed through a traditional introducer sheath, the sheath of theintroducer would have to be of a larger diameter than the deploymentsheath of the delivery catheter in order to accommodate the stent andthe deployment sheath.

FIG. 4 is a perspective view of another embodiment of a catheter system100 comprising an introducer catheter 102 (also referred to as anintroducer) and a delivery catheter 104. The delivery catheter 104 canbe configured for the delivery of an endoluminal prosthesis, or for anyother suitable use. Therefore, the embodiments of the catheters andintroducers disclosed herein can be configured for any suitable purpose,and the embodiments of the introducers disclosed herein can beconfigured to receive any suitable catheter design.

FIG. 5 is a perspective view of the embodiment of the introducer 102 ofthe embodiment of the catheter system 100 shown in FIG. 4. FIGS. 6A and6B are a first and a second exploded assembly view of the embodiment ofthe introducer 102 shown in FIG. 5. With reference to FIGS. 4-6, in someembodiments, the introducer 102 can have a main body 106, a threadablyengageable hub portion 108, an introducer sheath 110, and a threaded cap111 configured to threadably engage with a threaded end portion of themain body 106.

In some embodiments, a first tube 107 can be supported by the main body106 so as to provide an orifice or access port into the main body 106.The first tube 107 can be used to flush the introducer 102 with salineor other suitable substances at any stage, such as but not limited toprior to the advancement of an endoluminal prosthesis through theintroducer 102, or prior to other procedures for which an introducer maybe used. The first tube 107 can support any suitable medical connectorand/or valve on the distal end thereof.

The introducer sheath 110 can have an elongate portion 110 a extendingto any predetermined or desired length. As will be discussed in greaterdetail below, similar to the introducer 12 of the catheter system 10described above, in some embodiments, the introducer sheath 110 can beconfigured such that an endoluminal prosthesis that is advanced into theintroducer sheath 110 can be constrained or restrained by the introducersheath 110. In this arrangement, the inside and/or outside diameter ofthe introducer sheath 110 can be approximately the same as or similar tothe inside and/or outside diameter of the outer sheath of a deliverycatheter that is engaged with the introducer 102. In some embodiments,the elongate portion 110 a can be circular in cross-section (asillustrated), or can define any suitable cross-sectional shape such aswithout limitation triangular, square, hexagonal, octagonal, orpolygonal.

Further, as shown most clearly in FIG. 6A, the introducer sheath 110 canhave a flared end portion 110 b that can be configured to abut against afore surface 106 a of the main body 106. With reference to FIG. 6A, theelongate portion 110 a of the introducer sheath 110 can pass through anopening formed in the cap 111 so that the flared portion 110 b of theintroducer sheath 110 can be engaged with and/or overlap an insidesurface of the cap 111. In this configuration, the cap 111 supportingthe introducer sheath 110 can be threadedly engaged with the main body106 so that the introducer sheath 110 can be supported by the main body106.

Additionally, with reference to FIGS. 6A and 6B, a tubular support orspacer 109 can be inserted over the elongate portion 110 a of theintroducer sheath 110 and positioned approximately adjacent to theflared portion 110 b. The tubular spacer 109 can improve the fit and,hence, the seal between the outside surface of the introducer sheath 110and the cap 111. The tubular spacer 109 can also provide additionalsupport to the introducer sheath 110.

FIG. 7 is a perspective view of the embodiment of the delivery catheter104 of the embodiment of the catheter system 100 shown in FIG. 4. FIGS.8A and 8B are a first and second exploded assembly view of theembodiment of the delivery catheter 104 shown in FIG. 7. FIG. 9 is aperspective view of the embodiment of the catheter system 100 shown inFIG. 4, showing the delivery catheter 104 before the docking mechanismof the delivery catheter 104 has been engaged with the docking mechanismof introducer 102. FIG. 10 is a perspective view of the embodiment ofthe catheter system 100 shown in FIG. 4, showing the delivery catheter104 after the docking mechanism of the delivery catheter 104 has beenengaged with the docking mechanism of the introducer 102.

FIG. 11 is an end view of the embodiment of the catheter system shown inFIG. 4, with the delivery catheter 104 engaged with the introducer 102.FIG. 12 is a section view of the embodiment of the catheter system 100shown in FIG. 4, taken through the line 12-12 of FIG. 11. FIG. 13 is anenlarged section view of the embodiment of the catheter system 100 shownin FIG. 4, defined by curve 13-13 of FIG. 12. FIG. 14 is an enlargedsection view of the embodiment of the catheter system shown in FIG. 4,defined by curve 14-14 of FIG. 13. Finally, FIG. 15 is a section view ofthe embodiment of the catheter system shown in FIG. 4, taken through theline 15-15 of FIG. 11.

As shown most clearly in FIGS. 12 and 15, the hub portion 108 of theintroducer 102 can have a docking mechanism or flange 112 or can beconfigured to removably receive or engage with the delivery catheter104. In some embodiments, as in the illustrated embodiment, the dockingmechanism 112 of the introducer 102 can be configured to be a femalereceiver, configured to receive a male docking member of the catheter104, as will be described below. In some embodiments, the hub portion108 can comprise one or more tabs 114 configured to improve a user'sgrip on the hub portion 108, and ability to rotate the hub portion 108relative to the main body 106.

With reference to FIGS. 12, 13, and 15, some embodiments of the sealportion of the introducer 102 will be described. As mentioned above, thehub portion 108 can be configured to be threadably engageable with themain body 106. In some embodiments, the main body 108 can define aninner annular surface 116 that can be angled (so as to not beperpendicular to the axial centerline of the catheter system 100). Insome embodiments, the surface 116 can be angled approximately 75 degreesrelative to the axial centerline of the catheter system 100, or fromapproximately 65 degrees or less to approximately 80 degrees or morerelative to the axial centerline of the catheter system 100. In someembodiments, the surface 116 can be approximately perpendicular to theaxial centerline of the catheter system 100.

Similarly, in some embodiments, the hub portion 108 can define an innerannular surface 118 that can be angled so as to not be perpendicular tothe axial centerline of the catheter system 100. In some embodiments,the surface 118 of the hub portion 108 can be angled approximately 75degrees relative to the axial centerline of the catheter system 100, orfrom approximately 65 degrees or less to approximately 80 degrees ormore and relative to the axial centerline of the catheter system 100 ina direction that is opposite to the direction of the angle defined bythe surface 116 of the main body 106. In some embodiments, as in theillustrated embodiment, the shape and angular orientation of the surface118 of the hub portion 108 can approximately mirror the shape andangular orientation of the surface 116 of the main body 106. In someembodiments, the surface 118 can be approximately perpendicular to theaxial centerline of the catheter system 100.

An annular seal member 120 can be supported by the introducer 102 andpositioned between the surface 116 of the main body 106 and the surface118 of the hub portion 108. The seal member 120 can be formed from aresilient material, such as silicone, rubber or any other suitablematerial. The seal member 120 can be configured such that, when the hubportion 108 is threaded onto the main body 106, the surface 118 of thehub portion 108 can be moved axially toward the surface 116 of the mainbody 106, thereby compressing or squeezing the seal member 120. Therelative angles of the surface 116 of the main body 106 and the surface118 of the hub portion 108 can cause the seal member 120 to be forcedagainst an outer sheath 122 of the delivery catheter 104 or othercomponent of the delivery catheter 104 that is engaged with theintroducer 102, thereby creating an adjustable seal between the outersheath 122 of the delivery catheter 104, which can project distally froman end portion of the delivery catheter 104, and the introducer 102. Insome embodiments, the level of seal can be adjusted by tightening orloosening the hub portion 108 of the introducer 102 relative to the mainbody 106 of the introducer 102. In some embodiments, the introducer 102can be configured to provide a seal against devices with a profileranging from 1 Fr to 20 Fr.

Alternatively, in some embodiments, any of the seals or seal portionsdescribed herein can be an interference or close tolerance fit betweenadjacent components such as, without limitation, the outer sheath 122and one or more inside surfaces of the main body 106 or the hub portion108 of the introducer 102. In some embodiments, any of the seals or sealportions described herein can be an interference or close tolerance fitbetween the inner core 154 and one or more inside surfaces of the mainbody 140 or the hub portion 142 of the catheter 104.

As shown in FIGS. 7, 8A, and 8B, some embodiments of the deliverycatheter 104 can comprise a main body 140 and a hub portion 142threadably engageable with the main body 140. Some embodiments of thedelivery catheter 104 can also have an outer sheath 122 supported by themain body 140. In particular, the outer sheath 122 can be removablysupported by the main body 140 using a cap 123 threadably supported bythe main body 140. Further, in some embodiments, the outer sheath 122can have an elongate portion 122 a extending to any predetermined ordesired length.

As mentioned above, in some embodiments, the inside and/or outsidediameter of the outer sheath 122 of a delivery catheter 104 can beapproximately the same as or similar to the inside and/or outsidediameter of the introducer sheath 110. In some embodiments, the elongateportion 122 a can be circular in cross-section (as illustrated), or candefine any suitable cross-sectional shape such as without limitationtriangular, square, hexagonal, octagonal, or polygonal.

The outer sheath 122 can have a flared end portion 122 b that can beconfigured to abut against a fore surface 140 a of the main body 140.With reference to FIG. 8A, the elongate portion 122 a of the outersheath 122 can pass through an opening formed in the cap 123 so that theflared portion 122 b of the outer sheath 122 can be engaged with and/oroverlap an inside surface of the cap 123. In this configuration, the cap123 supporting the outer sheath 122 can be threadedly engaged with themain body 140 as mentioned above so that the outer sheath 122 issupported by the main body 140.

Additionally, with reference to FIGS. 8A and 8B, a tubular support orspacer 125 can be inserted over the elongate portion 122 a of the outersheath 122 and positioned approximately adjacent to the flared portion122 b of the outer sheath 122. The tubular spacer 125 can improve thefit and, hence, the seal between the outside surface of the outer sheath122 and the cap 123. The tubular spacer 125 can also provide additionalsupport to the outer sheath 122.

Similar to the hub portion 108 of the introducer 102, the hub portion142 of the delivery catheter 104 can be configured to be threadablyengageable with the main body 140 of the delivery catheter 104. In someembodiments, the main body 140 can define an inner annular surface 146that can be angled so as to not be perpendicular to the axial centerlineof the catheter system 100. In some embodiments, the surface 146 can beangled approximately 75 degrees relative to the axial centerline of thecatheter system 100, or from approximately 80 degrees or more toapproximately 65 degrees or less relative to the axial centerline of thecatheter system 100. In some embodiments, the surface 146 can beapproximately perpendicular to the axial centerline of the cathetersystem 100.

In some embodiments, a second tube 141 can be supported by the main body140 so as to provide an orifice or access port into the main body 140.The second tube 141 can be used to flush the delivery catheter 104 withsaline or other suitable substances at any stage, such as but notlimited to prior to the advancement of an endoluminal prosthesis throughthe delivery catheter 104 and/or introducer 102, or prior to otherprocedures for which an delivery catheter may be used. The second tube141 can support any suitable medical connector and/or valve on thedistal end thereof.

Similarly, in some embodiments, the hub portion 142 can define an innerannular surface 148 that can be angled so as to not be perpendicular tothe axial centerline of the catheter system 100. In some embodiments,the surface 148 of the hub portion 142 can be angled approximately 75degrees relative to the axial centerline of the catheter system 100, orfrom approximately 65 degrees or less to approximately 80 degrees ormore relative to the axial centerline of the catheter system 100 in adirection that is opposite to the direction of the angle defined by thesurface 146 of the main body 140. In some embodiments, the surface 148can be approximately perpendicular to the axial centerline of thecatheter system 100.

Similar to that of the introducer, in some embodiments, a seal or sealportion comprising an annular seal member 150 can be supported by thedelivery catheter 104 and positioned between the surface 146 of the mainbody 140 and the surface 148 of the hub portion 142. The seal member 150can be formed from a resilient material, such as silicone, rubber or anyother suitable material. The seal member 150 can be configured suchthat, when the hub portion 142 is threaded onto the main body 140, thesurface 148 of the hub portion 142 can be moved axially toward thesurface 146 of the main body 140, thereby compressing or squeezing theseal member 150. The relative angles of the surface 146 of the main body140 and the surface 148 of the hub portion 142 can cause the seal member150 to be forced against the inner core 154 of the delivery catheter104, thereby creating an adjustable seal between the inner core 154 theouter sheath 122 of the delivery catheter 104.

In some embodiments, the level of seal can be adjusted by tightening orloosening the hub portion 142 of the delivery catheter 104 relative tothe main body 140 of the delivery catheter 104. Additionally, in someembodiments, the rotational freedom of inner core 154 of the deliverycatheter 104 can be inhibited or prevented by tightening the seal member150 as described above. Thus, the force exerted by the seal member 150on the inner core 154 can be adjusted to permit the inner core 154and/or other components to rotate relative to the main body 140 and hubportion 142 of the delivery catheter 104. As illustrated in FIG. 4, anend portion or cap 158 can be supported at the proximal end of the innercore 154 to facilitate a user's ability to axially slide and/or rotatethat inner core 154 relative to the main body 140 and hub portion 142 ofthe delivery catheter 104. In some embodiments, the cap 158 can havewings or tabs formed thereon to increase the torque or rotational forcethat can be exerted on the inner core 154. Alternatively, in someembodiments, the seal or seal portion within the catheter 104 can beformed from an interference or close tolerance fit between adjacentcomponents such as, without limitation, the inner core 154 and one ormore inside surfaces of the main body 140 or the hub portion 142 of thecatheter 104.

In some embodiments, the inner core 154 can have a band or other marking155 near a distal end thereof. The marking 155 can be sized, positioned,and configured to provide a visual indication to the medicalpractitioner as to the location of the end portion 154 a of the innercore 154 and/or the location of a catheter tip 162 as the inner core 154is being advanced into or withdrawn from the introducer 102.

In some embodiments, as illustrated most clearly in FIGS. 12 and 13, anadditional seal member 160 can be supported by the main body 106 of theintroducer 102 to provide an additional seal between the outer sheath122 of the delivery catheter 104 and the introducer 102. In someembodiments, the seal 160 can be a flap type seal formed from aconically shaped piece of resilient material such as, but not limitedto, rubber having one or more slits therein to allow the distal tip 162and the outer sheath 122 to pass therethrough. In some embodiments, asupported flange 161 can be supported within the main body 106 andpositioned behind the seal 160 to support the seal 160 and maintain theposition of the seal 160 so that the seal 160 does not become invertedwhen the delivery catheter 104 is removed from the introducer 102. Insome embodiments, the distal tip 162 can be formed from a soft materialsuch as rubber and can be configured to be atraumatic so as to preventany damage to a patient's vasculature as the catheter 104 is beingadvanced through the patient's vasculature.

As mentioned above, in some embodiments, as in the illustratedembodiment, the docking mechanism 112 of the introducer 102 can beconfigured to receive a male docking member or portion of the catheter104. In particular, with reference to FIGS. 7, 8A and 8B, one or moredeflectable tabs 170 can be supported by the main body 140 of thecatheter 104. In some embodiments, the tabs 170 can be deflected bypressing or exerting a radial inward force against pads 172, causing theends of the tabs 170 to move radially inward toward the axial centerlineof the main body 104. By deflecting the tabs 170 inwardly, the main body140 of the catheter 104 can be moved axially into engagement with thehub portion 108 of the introducer 102. In some embodiments, the tabs 170can be automatically deflected inwardly when the main body 140 of thecatheter 104 is moved axially into engagement with the hub portion 108of the introducer 102. Once the main body 140 of the catheter 104 ismoved axially into engagement with the hub portion 108 of the introducer102 so as to abut against the hub portion 108 of the introducer, thetabs 170 can be released, thereby removably locking the main body 140 ofthe catheter 104 to the hub portion 108 of the introducer 102.

In this configuration, the catheter 104 can be axially engaged with orlocked to the introducer 102 so that a user can axially manipulate theintroducer 102 and the catheter 104 simultaneously. Additionally, insome embodiments, in this configuration, as discussed above, thecatheter system 100 can be configured such that at least the inner core154 of the catheter 104 can be rotated relative to the main body 140 ofthe catheter 104 and the introducer 102.

In some embodiments, as shown in FIGS. 7, 8A, and 8B, the inner core 154can have a central tube or wire 176 configured to support a stent, suchas stent 157 illustrated in FIGS. 7 and 12-14. Additionally, one or morebeads or tabs 174 can be formed on or supported by the central tube orwire 176. The tabs 174 can be configured to increase the axial supportor connection between the inner core 154 and an endoluminal prosthesissupported by the central tube 176 when the prosthesis is supported in acollapsed configuration by the central tube 176. In some embodiments,the catheter 104 can be configured such that an opening passes throughthe distal tip 162, the central tube 176, and the inner core 124. Theopening can be configured so that at least the distal tip 162, thecentral tube 176, and the inner core 124 can be advanced over aguidewire positioned within a patient's vasculature, such as isdescribed in U.S. patent application Ser. No. 12/101,863 filed on Apr.11, 2008 (titled: BIFURCATED GRAFT DEPLOYMENT SYSTEMS AND METHODS),which application is hereby incorporated by reference in its entirety asif fully set forth herein.

Additionally, in some embodiments (not illustrated), the tabs 174 can besized, spaced, and otherwise configured to provide axially support tomultiple individual stent segments. For example, without limitation,multiple independent or tethered stent segments can be positioned withina tubular or bifurcated graft, and the stent graft can be positionedrelative to the tabs 174 such that the tabs 174 are positioned betweenthe stent segments. This arrangement can reduce the overall diameter ofthe outer sheath 122, the introducer sheath 110, and other componentscomprising the catheter system, can enhance the axial support providedby the tabs 174 to the endoluminal prosthesis, and can allow for a moreuniform distribution of support forces between the tabs 174 and theendoluminal prosthesis. In some embodiments, the tabs 174 can be sized,spaced, and otherwise configured so as to be positioned adjacent to thelinks, bends, loops, and/or other connectors formed in a tubular orbifurcated stent, such as the links, bends, loops, and/or otherconnectors comprising the embodiments of the stents disclosed in U.S.Pat. No. 6,077,296 titled ENDOLUMINAL VASCULAR PROSTHESIS, which patentis hereby incorporated by reference as if fully set forth herein.

With reference to FIGS. 13-15, the outer sheath 122 of the deploymentcatheter 104 can be advanced into an axial opening within the introducer102 when the deployment catheter 104 is engaged with the introducer 102.In some embodiments, the outer sheath 122 can be sized and configuredsuch that the distal end portion 122 c of the outer sheath 122 canterminate within the introducer 102 prior or proximal to the proximalend or flared portion 110 b of the introducer sheath 110. Although notrequired, the introducer 102 can have a constricted portion 113 formedin the main body 106 of the introducer. In some embodiments, as shownmost clearly in FIG. 14, the catheter system 100 can be configured suchthat the distal end 122 c of the outer sheath 122 terminates prior to orapproximately adjacent to a constricted portion 113 of the main body 106of the introducer 102.

In some embodiments (not illustrated), the distal end portion 122 c ofthe outer sheath 122 can be positioned near to or approximately adjacentto the proximal end portion or the flared portion 110 b of theintroducer sheath 110, regardless of whether the catheter 104 has aconstricted portion 113. The inner diameter of the constricted portion113 can be approximately the same as the inner diameter of the outersheath 122 and/or the inner diameter of the introducer sheath 110.

Therefore, in some embodiments, the outer sheath 122 of the catheter 104and the introducer sheath 110 can be configured to provide a lumenhaving a generally uniform cross-sectional size through the cathetersystem through which the endoluminal prosthesis can be advanced. In someembodiments, the lumen through the catheter system 100 through which theendoluminal prosthesis can be advanced can be substantially continuous,so that the endoluminal prosthesis can be advanced through the cathetersystem 100 without the prosthesis being obstructed by or snagging on anycomponents or features of the catheter system 100 as it is beingadvanced. In some embodiments, the lumen can be substantially continuousbut have short gaps on the order of approximately 1 mm to approximately3 mm in the lumen such as, without limitation, adjacent to the distalend of the outer sheath 122 of the catheter 104 and/or adjacent to theproximal or flared end 110 b of the introducer sheath 110. For example,in some embodiments, short gaps can be formed adjacent to the distal endof the outer sheath 122 of the catheter 104 and/or adjacent to theproximal or flared end 110 b of the introducer sheath 110 as somecomponents comprising the catheter system 100 are threadedly engagedwith other components comprising the catheter system 100. Further, insome embodiments, one or more surfaces of other components comprisingthe catheter 104 or the introducer 102 in addition to the outer sheath122 and the introducer sheath 110, such as without limitation theconstricted portion 113 of the main body 106 of the introducer 102 asdiscussed above, can form portions of the lumen through the cathetersystem 100.

In some embodiments, the outer sheath 122 can constrain or restrain anendoluminal prosthesis supported by the central tube 176 as describedabove. In this configuration, as the catheter tip 162, central core 154,and an endoluminal prosthesis (such as, but not limited to, stent 157illustrated in FIGS. 7 and 12-14) are advanced through the outer sheath122, the outer sheath 122 can restrain the endoluminal prosthesis andprevent the endoluminal prosthesis from expanding before reaching thetarget position within the patient's vasculature. Additionally, thecatheter system 100 can be configured such that, as the catheter tip162, central core 154, and endoluminal prosthesis are advanced past thedistal end 122 c of the outer sheath 122, the constricted portion 113and, subsequently, the introducer sheath 110 can radially restrain theendoluminal prosthesis as the endoluminal prosthesis is advanced throughthe introducer sheath 110.

In some embodiments, the endoluminal prosthesis or the stent 157 can bea tubular stent, a bifurcated stent, or any other desirable stent,graft, stent graft, or endoluminal prosthesis (collectively referred toherein as stent or stents), including without limitation any of thestents or grafts disclosed in U.S. patent application Ser. No.12/101,863 referenced above and incorporated herein by reference as iffully set forth herein. Accordingly, in some embodiments, the cathetersystem 100 or catheter 104 can be configured to deploy any suitable ordesirable stent or stents.

Thus, in this configuration, the endoluminal prosthesis can betransferred from the outer sheath 122 to the introducer sheath 110. Inthis arrangement, using the introducer sheath 110 as the restraint canallow the outside diameter of the introducer sheath 110 to be reduced,which can minimize trauma to the patient's vasculature and assist in thedeployment of the endoluminal prosthesis.

Many embodiments of the docking mechanism and catheter system have beendescribed in connection with FIGS. 1-15. It will apparent to one ofordinary skill in the art that there are many potential embodiments of apermanent or removable docking mechanism that may be suitable formedical use and which are contemplated herein. For example, in someembodiments, a nut-screw combination could be used to connect theintroducer sheath and the catheter. As another example, a bayonet stylelocking mechanism, such as is used for camera lenses, can also be used.In some embodiments, any of the components or features of someembodiments of the catheters disclosed herein or other cathetersavailable in the field can be combined to form additional embodiments,all of which are contemplated herein.

While the above description has shown, described, and pointed out novelfeatures as applied to various embodiments, it will be understood thatvarious omissions, substitutions, and changes in the form and details ofthe device or process illustrated may be made without departing from thespirit of the disclosure. Additionally, the various features andprocesses described above may be used independently of one another, ormay be combined in various ways. All possible combinations andsubcombinations are intended to fall within the scope of thisdisclosure.

As will be recognized, certain embodiments described herein may beembodied within a form that does not provide all of the features andbenefits set forth herein, as some features may be used or practicedseparately from others. The scope of the inventions is indicated by theappended claims rather than by the foregoing description. All changeswhich come within the meaning and range of equivalency of the claims areto be embraced within their scope.

What is claimed is:
 1. A catheter system comprising: an introducercomprising a main body and a tubular introducer sheath projecting fromthe main body; and a catheter comprising a main body and an outer sheathprojecting from the main body, the outer sheath configured to be atleast partially advanced through the main body of the introducer;wherein when the introducer and the catheter are axially locked, thereis rotational freedom between the catheter and the introducer while astent or a stent graft is released from the catheter system; and whereinthe catheter further comprises an inner core that is configured to beadvanceable through the main body of the catheter and the outer sheath;and wherein the inner core is configured to be advanceable over aguidewire.
 2. The catheter system of claim 1, wherein the stent or thestent graft is axially supported by the catheter.
 3. The catheter systemof claim 1, wherein the outer sheath of the catheter does not overlapany portion of the tubular introducer sheath when the catheter isaxially locked with the introducer.
 4. The catheter system of claim 1,wherein a distal end portion of the outer sheath is positionedapproximately adjacent to a proximal end portion of the tubularintroducer sheath when the catheter is axially locked with theintroducer.
 5. The catheter system of claim 1, wherein an inner diameterof the outer sheath is approximately the same as an inner diameter ofthe tubular introducer sheath.
 6. The catheter system of claim 1,wherein the outer sheath and the tubular introducer sheath form a lumenhaving a substantially uniform cross-sectional size through the cathetersystem.
 7. The catheter system of claim 1, wherein the cathetercomprises at least one deflectable tab supported by the main body of thecatheter and the introducer comprises at least one flange, and the atleast one deflectable tab is configured to selectively engage with theat least one flange so as to axially engage the catheter with theintroducer.
 8. The catheter system of claim 7, wherein the catheter isconfigured to disengage from the introducer by deflecting the at leastone deflectable tab radially inwardly toward an axial centerline of thecatheter and axially retracting the catheter away from the introducer.9. The catheter system of claim 1, wherein when the introducer and thecatheter are axially locked, axial movement of either of the introducerand the catheter in a proximal or a distal direction will cause asimultaneous and equal axial movement of the other of the introducer andthe catheter so as to prevent the movement of either of the introducerand the catheter relative to the other of the introducer and thecatheter.
 10. The catheter system of claim 1, further comprising alocking element configured to selectively lock the catheter to theintroducer in an axial direction such that, when the introducer and thecatheter are axially locked, axial movement of either of the introducerand the catheter in a proximal or a distal direction will cause asimultaneous and equal axial movement of the other of the introducer andthe catheter so as to prevent the movement of either of the introducerand the catheter relative to the other of the introducer and thecatheter.
 11. The catheter system of claim 1, wherein the cathetersystem is configured to prevent an outer sheath of the catheter fromadvancing into the introducer sheath when the catheter has reached afully advanced position in the introducer.
 12. A catheter systemcomprising: an introducer comprising a main body and a tubularintroducer sheath projecting from the main body; and a cathetercomprising a main body and an outer sheath projecting from the mainbody, the outer sheath configured to be at least partially advancedthrough the main body of the introducer; wherein when the introducer andthe catheter are axially locked, the catheter is freely rotatable withinthe introducer sheath; wherein the catheter further comprises at leastone deflectable tab supported by the main body of the catheter, the atleast one deflectable tab configured to selectively engage theintroducer by distally advancing a distal free end of each of the atleast one deflectable tab into a proximal end of the main body of theintroducer; wherein the catheter further comprises an inner core that isconfigured to be advanceable through the main body of the catheter andthe outer sheath; and wherein the inner core is configured to beadvanceable over a guidewire.
 13. The catheter system of claim 12,further comprising a stent or a stent graft axially supported by thecatheter.
 14. The catheter system of claim 12, wherein the catheter isconfigured to be disengaged from the introducer by deflecting the atleast one deflectable tab radially inwardly toward an axial centerlineof the catheter.
 15. The catheter system of claim 12, wherein the outersheath and the tubular introducer sheath form a lumen having asubstantially uniform cross-sectional size through the catheter systemthrough which a stent or a stent graft can be advanced.
 16. The cathetersystem of claim 12, wherein the introducer comprises at least oneflange, the at least one deflectable tab being configured to selectivelyengage with the at least one flange so as to axially engage the catheterwith the introducer.
 17. A catheter system comprising: an introducercomprising a main body and a tubular introducer sheath projecting fromthe main body, the tubular introducer sheath comprising a proximal endportion extending from the main body and a distal end portion; acatheter comprising a main body and an outer sheath projecting from themain body, the outer sheath comprising a proximal end portion and adistal end portion, the outer sheath configured to be at least partiallyadvanced through the main body of the introducer; and wherein when theintroducer and the catheter are axially locked, the catheter is fullyrotatable within the introducer sheath; wherein the tubular introducersheath is configured to directly radially restrain a stent or a stentgraft after the stent or the stent graft has been axially advanced pastthe distal end portion of the outer sheath and the proximal end portionof the tubular introducer sheath; wherein the catheter further comprisesan inner core that is configured to be advanceable through the main bodyof the catheter and the outer sheath; and wherein the inner core isconfigured to be advanceable over a guidewire.
 18. The catheter systemof claim 17, further comprising a stent or a stent graft axiallysupported by the catheter.
 19. The catheter system of claim 17, whereina distal end portion of the outer sheath is positioned approximatelyadjacent to a proximal end portion of the tubular introducer sheath whenthe catheter is axially engaged with the introducer.
 20. The cathetersystem of claim 17, wherein the outer sheath and the tubular introducersheath form a lumen having a substantially uniform cross-sectional sizethrough the catheter system through which the stent or the stent graftcan be advanced.
 21. The catheter system of claim 17, wherein thecatheter comprises at least one deflectable tab and the introducercomprises at least one flange, and the at least one deflectable tab isconfigured to selectively engage with the at least one flange so as toaxially engage the catheter with the introducer.